@article{984b4ec747a24200a068a0a8c647f79e,
title = "Altered fetal growth, placental abnormalities, and stillbirth",
abstract = "Background: Worldwide, stillbirth is one of the leading causes of death. Altered fetal growth and placental abnormalities are the strongest and most prevalent known risk factors for stillbirth. The aim of this study was to identify patterns of association between placental abnormalities, fetal growth, and stillbirth. Methods and findings: Population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in 5 geographic areas in the U.S. Fetal growth abnormalities were categorized as small (<10th percentile) and large (>90th percentile) for gestational age at death (stillbirth) or delivery (live birth) using a published algorithm. Placental examination by perinatal pathologists was performed using a standardized protocol. Data were weighted to account for the sampling design. Among 319 singleton stillbirths and 1119 singleton live births at ≥24 weeks at death or delivery respectively, 25 placental findings were investigated. Fifteen findings were significantly associated with stillbirth. Ten of the 15 were also associated with fetal growth abnormalities (single umbilical artery; velamentous insertion; terminal villous immaturity; retroplacental hematoma; parenchymal infarction; intraparenchymal thrombus; avascular villi; placental edema; placental weight; ratio birth weight/placental weight) while 5 of the 15 associated with stillbirth were not associated with fetal growth abnormalities (acute chorioamnionitis of placental membranes; acute chorioamionitis of chorionic plate; chorionic plate vascular degenerative changes; perivillous, intervillous fibrin, fibrinoid deposition; fetal vascular thrombi in the chorionic plate). Five patterns were observed: placental findings associated with (1) stillbirth but not fetal growth abnormalities; (2) fetal growth abnormalities in stillbirths only; (3) fetal growth abnormalities in live births only; (4) fetal growth abnormalities in stillbirths and live births in a similar manner; (5) a different pattern of fetal growth abnormalities in stillbirths and live births. Conclusions: The patterns of association between placental abnormalities, fetal growth, and stillbirth provide insights into the mechanism of impaired placental function and stillbirth. They also suggest implications for clinical care, especially for placental findings amenable to prenatal diagnosis using ultrasound that may be associated with term stillbirths.",
author = "{Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Stillbirth Collaborative Research Network (SCRN)} and Radek Bukowski and Hansen, {Nellie I.} and Halit Pinar and Marian Willinger and Reddy, {Uma M.} and Parker, {Corette B.} and Silver, {Robert M.} and Dudley, {Donald J.} and Stoll, {Barbara J.} and Saade, {George R.} and Koch, {Matthew A.} and Carol Hogue and Varner, {Michael W.} and Conway, {Deborah L.} and Donald Coustan and Goldenberg, {Robert L.}",
note = "Funding Information: This work including the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review and approval of the manuscript was supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U10-HD045953 Brown University, Rhode Island; U10-HD045925 Emory University, Georgia; U10-HD045952 University of Texas Medical Branch at Galveston, Texas; U10-HDO45955 University of Texas Health Sciences Center at San Antonio, Texas; U10-HD045944 University of Utah Health Sciences Center, Utah; and U01-HD045954 RTI International, RTP. Program officers from the funding agency (Reddy and Willinger) were members of the Steering Committee of the study, and contributed to the study design, management, interpretation of the data, as well as preparation, review and approval of the manuscript. Otherwise the funders did not have any involvement in the design of the study; the collection, analysis, and interpretation of the data; the writing of the article; or the decision to submit the article for publication. This work including the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review and approval of the manuscript was supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U10-HD045953 Brown University, Rhode Island; U10-HD045925 Emory University, Georgia; U10-HD045952 University of Texas Medical Branch at Galveston, Texas; U10-HDO45955 University of Texas Health Sciences Center at San Antonio, Texas; U10-HD045944 University of Utah Health Sciences Center, Utah; and U01-HD045954 RTI International, RTP. Program officers from the funding agency (Reddy and Willinger) were members of the Steering Committee of the study, and contributed to the study design, management, interpretation of the data, as well as preparation, review and approval of the manuscript. Otherwise the funders did not have any involvement in the design of the study; the collection, analysis, and interpretation of the data; the writing of the article; or the decision to submit the article for publication. The Stillbirth Collaborative Research Network is solely responsible for the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The following institutions and researchers comprise the Stillbirth Collaborative Research Network: University of Texas Health Science Center at San Antonio–Donald J. Dudley, Deborah Conway, Karen Aufdemorte, Angela Rodriguez, Monica Pina; University of Utah School of Medicine–Robert M. Silver, Michael W. Varner, Kristi Nelson; Emory University School of Medicine and the Rollins School of Public Health–Carol J. Rowland Hogue, Barbara Stoll, Janice Daniels Tinsley, Bahig Shehata, Carlos Abramowsky; Brown University–Donald Coustan, Halit Pinar, Marshall Carpenter, Susan Kubaska; University of Texas Medical Branch at Galveston–George R. Saade, Radek Bukowski, Jennifer Lee Rollins, Hal Hawkins, Elena Sbrana; RTI International–Corette B. Parker, Matthew A. Koch, Vanessa R. Thorsten, Holly Franklin, Pinliang Chen; Pregnancy and Perinatal-ogy Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health–Marian Willinger, Uma M. Reddy; Columbia University School of Medicine–Robert Goldenberg. We would like to acknowledge the members of the NICHD Scientific Advisory and Safety Monitoring Board for their review of the study protocol, materials, and progress, as well as all of the other physicians, study coordinators, research nurses, and patients who participated in the Stillbirth Collaborative Research Network. Publisher Copyright: {\textcopyright} 2017, Public Library of Science. All rights reserved. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.",
year = "2017",
month = aug,
doi = "10.1371/journal.pone.0182874",
language = "English (US)",
volume = "12",
journal = "PloS one",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",
}